Comparison of specific and non-specific treatment approaches for individuals with posterior capsule tightness and shoulder impingement symptoms: A randomized controlled trial

Background: Posterior capsule tightness (PCT) is associated with shoulder pain and altered shoulder kinematics, range of motion (ROM), external rotation (ER) strength, and pain sensitization. Objective: To assess the effects of two interventions on shoulder kinematics, Shoulder Pain and Disability Index (SPADI) scores, ROM, strength, and pressure pain threshold (PPT) in individuals with PCT and shoulder impingement symptoms. Methods: In this prospectively registered randomized controlled trial 59 individuals were randomized to either an Experimental Intervention Group (EIG, n=31) or a Control Intervention Group (CIG, n=28). The low flexion (LF) test was used to determine the presence of PCT. Shoulder kinematics, SPADI scores, internal rotation (IR) and ER ROM, ER strength, and PPTwere measured preand post-treatment. Those in the EIG received an intervention specific to pain and PCT and those in the CIG received a non-specific intervention, both 4 weeks in duration. Results: Individuals in the EIG demonstrated more scapular upward rotation (P=.03; mean difference (MD)=3.3 degrees; 95% Confidence Interval (CI)=1.3 degrees, 4.9 degrees) and improved value on the LF test (P=.02; MD=4.6 degrees; 95%CI=0.7 degrees, 8.6 degrees) than those in the CIG after treatment. Both groups presented less anterior (P<.01; MD=-0.7mm; 95%CI=-1.3mm, -0.2mm) and superior (P<.01; MD=0.5mm; 95%CI=-0.9mm, -0.2mm) humeral translations, decreased SPADI score (P<.01; MD=-23.6; 95%CI=-28.7,-18.4), increased IR ROM (P<.01; MD=4.6 degrees; 95%CI=1.8 degrees, 7.8 degrees) and PPTs for upper trapezius (P<.01; MD=60.1kPa; 95%CI=29.3kPa, 90.9kPa), infraspinatus (P=.04; MD=47.3kPa; 95%CI=2.1kPa, 92.5kPa), supraspinatus (P<.01; MD=63.7kPa; 95%CI=29.6kPa, 97.9kPa), and deltoid (P<.01; MD=40.9kPa; 95%CI=12.3kPa, 69.4kPa) after treatment. Conclusion: The experimental intervention was more effective at improving PCT as measured through changes in the LF test. No benefit of the specific approach over the non-specific intervention was noted for the remaining variables. (c) 2021 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Espana, S.L.U. All rights reserved.

Automated summary

This study aimed to assess the effects of two interventions on individuals with PCT and shoulder impingement symptoms. Results showed that the experimental intervention group demonstrated better outcomes in scapular upward rotation and LF test value, with improvements in other variables for both groups.